Intermittent Catheterization - What, Why, and How
What Is Intermittent Catheterization?
Intermittent catheterization refers to periodic insertion of a plastic tube (catheter) through the urethra and sphincter muscle into the bladder. This allows urine to drain from the bladder. If this is done at regular intervals, so that the bladder does not become overstretched, the risks of infection and bleeding are minimal.
Why Do Intermittent Catheterization?
When the bladder cannot be emptied, the options are either:
1) To drain the bladder continuously by a catheter through the urethra or through the skin above the pubic bone (suprapubic tube), or
2) Intermittent catheterization.
The advantages and health benefits of intermittent catheterization are:
- Avoids overstretching of the bladder, which can destroy bladder muscle. and risk damage to the kidneys
- Reduces risk of infection, as bacteria may multiply in retained (residual) urine
- Reduces urinary leakage (incontinence), so you can be more active, confident, and healthy.
Why Is It Clean Rather Than Sterile?
Unless patients have a poor immune system (imunosuppressed), regular timed drainage of the bladder prevents the tiny bit of bacteria introduced with catheterization from developing into a clinical or symptomatic infection. Thus, clean technique is suitable for most patients.
How To Perform Intermittent Catheterization
Your physician, physician’s assistant, nurse and other members of the health care team have determined that intermittent catheterization will help maintain a healthy bladder, keeping you drier and preventing infections. They will teach you how to do the catheterization, guide you on a schedule of when to catheterize, and advise you on which catheter is best for you to use.
This may seem like a difficult task starting out, but with a little practice, you will quickly become an expert. Thousands of people, even young children, catheterize themselves every day after learning this technique.
• Steps To Clean Intermittent Catheterization – Female
1. Assemble equipment in an accessible area: catheter, water-soluble  lubricant, moist towelette or soap and water, and dry hand towel.
2. Inspect catheter before use. Discard if the catheter is damaged.
3. Wash hands thoroughly with soap and water, and dry.
4. Position yourself comfortably on the toilet seat, or in a chair across from the toilet, with the thighs spread apart.
5. With one hand, separate the labia and wash from front to back with soap and water or a moist towelette.
6. Lubricate the catheter end that will go into the urethra, using a water soluble lubricant on about 2 inches of the catheter tip.
7. Slowly and gently insert the catheter into the urethra until the urine begins to flow (about 1-1.5 inches). Then push the catheter in about 1 inch further, and hold it there until the urine stops flowing.
8. When the urine stops, slowly withdraw the catheter, slightly rotate the catheter as you withdraw, and stop each time more urine drains out.
9. Check the color, odor, and clarity of the urine to make sure there are no signs of infection that you need to report to your doctor or nurse.
• Steps To Clean Intermittent Catheterization – Male
1. Assemble equipment in an accessible area: catheter, water-soluble lubricant, moist towelette or soap and water, and dry hand towel.
2. Inspect catheter before use. Discard if the catheter is damaged.
3. Wash hands thoroughly with soap and water, and dry.
4. Position yourself comfortably in front of the toilet, or in a chair across from the toilet. Many men prefer to stand during the catheterization procedure.
5. Hold the penis up with one hand, wash the urethral opening area and head of the penis with soap and water or a moist towelette. Use a circular motion starting at the urethra and working outward.
6. Lubricate the catheter end that will go into the urethra, using a water soluble lubricant on about 4-6 inches of the catheter tip.
7. Hold the penis straight up from the body at a 60 to 70 degree angle for the body. Slowly and gently insert the catheter with the tip up (aiming towards your abdomen) into the urethra. When you feel resistance about 4-5 inches in, you are at the sphincter. Here, you need to try to relax to urinate while you advance the catheter past it until the urine begins to flow (about 6-8 inches). Then push the catheter in about 1 inch further, and hold it there until the urine stops flowing.
8. When the urine stops, slowly withdraw the catheter, slightly rotate the catheter as you withdraw, and stop each time more urine drains out.
9. Check the color, odor, and clarity of the urine to make sure there are no signs of infection that you need to report to your doctor or nurse.
FAQ about Clean Intermittent Catheterization
• Q: What kind of supplies will I need?
A: You will need:
1. A catheter;
2. Soap and water to wash your hands before and after your catheterization;
3. Water soluble lubricant to help the catheter slide more easily in the urethra;
4. Moist towelettes (like Wash ‘N Dry) to clean the area around the urethral opening before catheterizing;
5. A plastic zip-lock baggie or a travel toothbrush holder to carry your catheters with you at all times.
• Q: Where can catheterization be done?
A: Anywhere you can find some privacy. Many individuals prefer to use the toilet, but you may drain the catheter into any other container for disposal, such as a leg bag, night drainage bag, empty milk carton, coffee can, urinal, or plastic bag.
• Q: How often should I catheterize?
A: Your doctor or nurse will help you establish a regular schedule that best suits your needs. When you begin, you may be asked to keep a record of your catheterizations so that the schedule may be adjusted if the volumes change. Usually, it is recommended that you catheterize every 4-6 hours, trying to keep the combined amount that you urinate on your own plus the amount that you catheterize around 500-600 cc. That prevents the bladder from getting overstretched, where scar tissue might replace healthy muscle tissue.
• Q: Should I limit the fluids I drink?
A: Every person needs daily fluids to maintain good health. Eight 8 ounce glasses of liquid a day is recommended. You might need to limit your fluid intake several hours before bedtime to help you stay dry overnight. Beverages containing caffeine (coffee, tea, and cola drinks) may irritate the bladder, so you may want to limit them to 2 or 3 cups per day.
• Q: What about sexual activity and catheterization?
A: Intermittent catheterization should not interfere with sexual activity. You may discuss your concerns with your doctor or nurse. It is generally advised to empty the bladder before and after having sexual intercourse.
• Q: How often should I see my doctor?
A: You should always see your doctor based on his or her recommendation for regular checkups. Notify your physician or nurse at once if you experience cloudy or foul-smelling urine, pain or burning when inserting the catheter or while urinating, bloody urine, fever, chills, back pain, or inability to get the catheter into the bladder.
• Q: What about medications?
A: Your doctor may recommend medications to decrease risk of infections or bladder spasms when you are first starting intermittent catheterization. Make sure any medications you are taking do not interact with any of these medications.
• Q: How do I know when to catheterize?
A: You should catheterize every 4-6 hours as prescribed by your doctor or nurse. The following signs may be an indication that it is time to catheterize: restlessness, perspiration, chills, headache, distended bladder and feeling fullness.
• Q: What is the difference in the size of the catheter?
A: The diameter of the catheter is measured in a unit called French (Fr), which is 3 times the diameter of the tubing in millimeters. Thus, a 12 Fr catheter is 4 mm diameter. Catheters used for intermittent catheterization range from 5 to 20 Fr, with the most common being 12 and 14 Fr for adults.
|
